Monday, September 19, 2011

Sadbh's update - day 161 part 2


Katie was up at 1:30am this morning to feed Sadbh ahead of the 2am cut off. Everything went well and Sadbh was back in a deep sleep before 2.

Our plan was to leave the house around 6:15am, which should get us to Children’s in time for check in.
By 5:45am, Sadbh was wide awake, hungry and extremely upset.

We have both dealt with Princess Angry Bird on many an occasion, however this morning since we could not give Sadbh what she wanted, it was a heart breaking ordeal.

Once in the car, she calmed down somewhat, but every so often she would get upset and work herself into a frenzy.

By the time we reached the hospital, she was well worn out, and was very tired.
We quickly checked in and in an effort to keep Sadbh calm, I kept walking her around the waiting area to keep her distracted with all the great art and the huge stain glass whale hanging from the ceiling.

This worked a treat until she would turn her focus to me and then start bawling crying.

We were first on the list for surgery this morning and the admitting nurse quickly processed Sadbh and got the ball rolling with the anesthesiology team.
Sadbh had to be weighed and measured as part of her check in, and despite arriving at the hospital in the form of Princess Angry Bird, when all the nurses in the surgery prep station commented on how cute she was, she turned to them and gave a huge flirtatious smile. And when done flirting, Princess Angry Bird returned.

Sadbh weighed in at 14lbs and measured 24 inches. On August 8th, she weighted 12lbs 6 ounces and measured 23 and ¾ inches.

The nurse provided us with a hospital gown for Sadbh and I have to say, it is the cutest thing I have ever seen.

Doctor Inglis popped in to see how Sadbh was doing and briefly went over what his objective was and what we should expect.

Soon afterwards we met with the anesthesiology team to go over their procedure and what to expect, moments later we kissed her good bye and off she went.

With that, Katie and I headed off to grab a coffee and wait to get paged from the doctor.

The entire procedure was estimated to last approximately 45 minutes, but just after we spotted Waldo (or Wally as he his know back in Ireland) in the construction site, the pager went off and we quickly made our way back to the post op conference room assigned to us.

Dr. Inglis was encouraged by what he saw.
He could tell that Sadbh’s vocal cords have strong closing capabilities and this would be promising for her voice and speech development.
Since she was under anesthetic, he could not get a sense of how her vocal cords performed when trying to open, so we will have to wait for our next appointment to see how well they are developing.

As expected, Sadbh did have some granuloma inside her airway, just above the trach. With that, Dr. Inglis was able to remove this scar tissue with the use of laser and our next steps are to start using the Passy Muir trach valve by the end of the week.

He did present us with a number of options with todays results.

The first option was to continue as we are until her vocal cords either fix themselves or when she is older and can go through some corrective surgery without compromising her voice.

The next option would be to make an incision in her neck, into the airway, just below the vocal cords, then he would pass a suture into her airway, suction it up through her mouth. He would then make another incision directly above her vocal cords and pull the suture back out pulling the vocal cords up against the side of her airway.
This is common in older children and adults, but not in infants. There is also a chance that this could affect her voice and speech development.

The third option would be to slice the vocal cords allowing them to open without much difficulty.
There is a chance that this would also affect her voice.

The fourth option would be to insert a type of splint that would force the vocal cords open.
There is a risk that as she grows, the splint might become dislodged and need to be replaced.

His recommendation, and our preferred option is the first one. To keep on the course that we are currently on and hope that the vocal cords correct themselves.

After meeting with Dr. Inglis, we made our way to the post op waiting room to meet our baby, and it wasn’t long before she arrived all groggy and confused.

Since she is under 6 months old, we had to hang out for 4 hours afterwards so they could monitor her recovery and to make sure she did not have any complications.
Katie quickly fed Sadbh and despite still feeling the effects of the anesthetic, she had a ferocious appetite and did not waste any time.
Once fed, she fell into a drugged slumber and was very peaceful for the next hour or so.

Her post op recovery went great and shortly before 3pm we were discharged and on our way home.

Around 5pm, we got to interview another potential nurse that we hope can start back filling some of the night shifts. She has a daughter that is only 2 days younger than Sadbh, so we are confident that she should be dialed into Sadbh’s development needs.

Sadbh was in great form for the rest of the evening, it seems that she is healing well and is over the trauma of the mornings events.
She is such a tough little girl, I am so impressed with her strength, apart from when she is hungry.



Take care,

Wayne, Katie and Princess Sadbh.

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